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The Insurance Companies Are Corrupt So What Can We Do?

It seems that the insurance companies are the most corrupt and vile of all. They have gotten away with murdering us over money. They are supposed to be for us???

We need to tell everybody about this. This means telling your friends neighbors etc. Somehow the tide needs to be turned.

Soon there will be House Ways and Means Committees set up to hear the plight. We need to somehow get our representives there. Any takers??

From how I see it at present, there are few people listening to the true plight. It even seems that this site is ineffective because injured workers just fight among themselves and thus lose their power. Is this the way we want it, or is it the way it is being let go???

Many people who are effective have left, and are on there way to helping in different ways. Helping here doesn&#39;t seem effective to me at least. While it may be argued, I for one have lost my desire to participate in this place due to the problems here. If one says something they have to dodge the bullets. Geeze, there is so much more to be done then to fight among the masses. That goes with social theory however, divide and conquor. So be it!!

There is much work to do. But I don&#39;t think it is on this site. Wonder how long this will last without being deleated?

From: Mary Bailey
Over the past several years we have watched the legislative process concerning workers compensation. Of course there is always mention of fraud and exorbitant attorney fees. Of course the fraud is always committed by someone other than the carrier. Of course the answer to the problem is capping claimant attorney fees and further restricting the rights of injured workers. And of course there are no restrictions placed on defense attorney fees while the carriers trample on the rights of those who can&#39;t afford to defend themselves.

The concerns are about keeping businesses in the state. Concerns about keeping insurance carriers in this state. And of course there are concerns about reasonable premiums and availability of comp coverage, especially for small businesses.

Where are the concerns about the humanity, justice, and well being of those injured and their families? Who is asking who will be willing to work in Florida in the future? Who is asking what is the human cost of the workers compensation systems across America?

Every day millions of people innocently go to work and do the jobs they were hired to do. They will be most fortunate if they never have a serious work injury. They have control over their futures and the futures of their families. They have control over how many jobs they will work, where, and when. They have control over their financial destiny. They decide when they will retire or when they will not. They have years to plan their retirement funds. They have options for health insurance, life insurance, and disability insurance. They get to choose their own doctors and be an active participant in their health care.

Where are the options for those less fortunate? Where are the options for injured workers? What happened to the exchange made in the exclusive remedy for workers compensation victims? A change I might add that was never voted upon by the working people of America. A change that was forced on us by our elected officials. A change that was intended to do good things but as always politics has corrupted the noblest of intentions.

At first I really thought it was a lack of education on the part of our elected officials to allow something that&#39;s intent was meant to be so good to go so wrong. To some degree it is a lack of understanding on our lawmakers part. However it is the job of those elected to office to educate themselves on issues most important to the people they represent. That means all the people. Not just those with money for campaign contributions.

How hard is it to really fix the workers compensation systems of America? I think a better question is who really wants to fix the workers compensation systems of America and at what human cost? The fixes to the comp system are simple. Instead of fixing the comp crisis once and for all across America, our elected officials put Band-Aids on the problems like moving around deck chairs on a sinking ship. They know their solutions are wrong. They even have trouble convincing themselves that their solutions are the right thing. They know they are responding to the pressures of their party and special interest groups while selling out the average citizen. Most politicians really want to do the right thing I believe, but they are stuck in election campaigns that are expensive and often funded by special interest groups. Believe me for every dollar special interest gives, special interest collects.

They know that they have done nothing to stop the crisis. They know that comp will be back in the legislature each and every year. They know that premiums will continue to climb while benefits decrease and while the rights of those affected decline. They continually pass the buck hoping that they won&#39;t have to really address the issue during their term in office. Let the problem fall to the next guy. It is an unpopular subject to deal with after all.

So while all of this is going on what is the human cost? Who suffers in the meantime? Is it just the injured worker? Of course not. It all starts out with a person going to work just like any other day. Then something tragic happens and the person is unfortunate and sustains a serious injury as opposed to one that only needs little medical treatment.

Thus the nightmare begins. The injured employee is sent to a comp specialist who assures him/her that everything is okay. Believing that doctors know what they are talking about and not knowing the hold the insurance carriers have over the comp system the injured worker innocently believes the doctor. He/she returns to work or rests at home believing he/she has only sustained a minor injury.

But then weeks go on and the pain is still there. His/her family becomes frustrated because there is nothing they can do to help him/her. The carrier starts sending you on an IME merry-go-round. Still the injured worker believes he/she is in good hands and the health problems will be taken care of. Then comes the denials of the medical treatments ordered by the doctors the carriers chose for the injured worker.

Then comes the rumors from work. Your coworkers are no longer allowed to talk to you if they want to keep their jobs. Suddenly you start hearing that you are a fraud or you are a malingerer exaggerating your injury. Then you start noticing an unusual car parked outside and hearing from your neighbors that a private investigator is going around talking with your neighbors and insinuating that you are being investigated for comp fraud. Your children become scared because they don&#39;t know who is watching them and following them to school as well as following you and your family any where you may decide to go.

Then comes the letter saying you have been fired from your job on trumped up charges or that the company has downsized and unfortunately your position has been eliminated. This is where all injured workers begin to become aware of the <FONT COLOR="ff0000"></FONT> of a life they have been thrown into as a result of their work injury.

As time goes by you are not getting the needed medical care so you go to the EAO office for assistance. In some cases they are helpful, however if the carrier refuses to work with them you have no other option than to file a petition for benefits. Most injured workers never even think of getting an attorney until they are caught between a rock and a hard place. &#34;Who would have thought I would need an attorney to get benefits the laws say I am entitled to,&#34; they often say to me.

Then after exhausting all other avenues the injured worker decides to hire an attorney if he/she can find one to take the case. It normally takes an injured worker approximately one year before considering hiring an attorney. There just are no other options available to the injured worker because the state does not enforce the law.

The injured worker is already feeling insecure and lazy for not being able to work and provide for his/her family. He/she is bored to death because he/she has been working all of his/her life and even though the pain is intense and the medications cause him/her to sleep he/she still feels he/she ought to be out doing something.

After hiring an attorney he/she finds out that this injury is more serious than first thought. He/she is going to be out of work either temporarily or permanently. The ironic thing is the doctor said if he/she had received the prescribed treatment at an earlier date that he/she would already be back to work.

Unknown to the injured worker at this time, the battle has just begun. He/she is in for the fight of his/her life. The family is tired of him/her being sick all the time and the moodiness he/she displays out of frustration in the comp system. The children and sometimes the spouse don&#39;t understand why mommy or daddy are no fun anymore. They can&#39;t understand why there is never any extra money. Why they can&#39;t sit on mommy or daddy&#39;s lap anymore. Why can&#39;t they go to the doctor when they are sick and why does the electric, water and phones keep getting cut off? Why is there never any food in the house and what has changed so much that there is never enough to eat?

Mommy or daddy always seem so very worried and definitely short tempered. Sometimes he/she never even gets out of bed each day. Mommy and daddy fight all the time. Why can&#39;t the doctor just make it all better? The injured worker has become so depressed by his/her treatment in the comp system that he/she begins to lose his/her self esteem. He/she wonders which is worse, the workers compensation system or the initial injury. He/she actually wonders if the family wouldn&#39;t be better off without him/her.

Between the pain and depression he/she often thinks of suicide as the only way out of this awful mess. Thank God, there are support groups around to see him/her through the rough times and remind him/her how much his/her family needs him/her.

Then there is the acceptance thing. It is so hard to accept a permanent disability. The injured workers whole future is now shot leaving him/her to the mercy of the workers compensation system for the rest of his/her life and it has been a very adversarial system to live in so far. Could it always be this bad? How will he/she fill the hole left in his/her gut by the reality of his/her injury? I mean who wants to be nonproductive? Who wants to wake up each day and watch the world go by leaving him/her behind? Somehow the void has to be filled but with what?

He/she can&#39;t consistently do anything because he/she has no idea which day will be a good day and which one will be bad. He/she has doctors appointments to go to and he/she tires so much easier than he/she used to. When the pain is bad the meds he/she is on makes him/her sleep all the time.

All of these things wear on the family. Divorces often follow. The spouse and the children are often either on Welfare, Medicaid, or Social Security. No other insurance is affordable and it is now considered a luxury as opposed to a necessity.

The kids are hungry, need new clothes, and need to go to the dentist. Who will be paying for all of that or is that just one of the hidden human costs? The injured worker is so stressed that he/she cannot provide the necessities for his/her family and he/she has no idea how to make things better. He/she draws closer to a nervous breakdown with the draw of each breath.

The older kids drop out of school to help provide for their family. The younger ones just plain don&#39;t understand why everything is so different. By now all the money that he/she has saved is gone and he/she is one step closer to homelessness. He/she has already sold everything of any value. Where do I go from here? A week later he/she is now living on the streets compliments of an on the job injury and the comp system. Still a mediation and court date has not been set. It can take years to get to a final hearing in the workers compensation system.

The family has not only fallen apart but has also fallen into poverty and homelessness. The comp carrier is still jerking him/her around with no relief to his/her harassment in sight. The injured worker still has never gotten the prescribed treatment by his/her doctor. The injury is much worse, if not life threatening, and will cost three times more for treatment than it would have had it been treated promptly. The saddest part of this whole thing is that there are laws in place to stop this kind of human suffering. Unfortunately they are rarely, if ever, enforced.

So again I ask at what human cost? How long will our elected officials allow this kind of suffering to go on? How long will society itself allow this to go on? There are ways to fix this problem but no one seems to be willing to do that because it is not what the special interest groups want. Once again I ask WHAT IS THE HUMAN COST? When will the injured workers become the true priority of the comp system? The people it was designed for. When will human life be more important than the almighty insurance dollar?

Re: The Insurance Companies Are Corrupt So What Can We Do?

My VR retraining program has been terminated because they say I don't live in the state I was injured in. At my WC trial in April of 2007, the judge made the insurance lawyer write out a contract saying they were responsible for VR retraining of which I had to sign right before the judge. They asked me if I'd be willing to move back to the state of CA to be retrained and I told them I would. This is the only thing I received except for five months of VR payments while I'm supposed to be in school but I have not received any information from my VR counselor or the insurance company as to when and where I have to go to school at. Don't you think they should have contacted me before they terminated me? They were trying to get out of paying these benefits as far back as 2003 and that's why the judge gave me such a big penalty award. How far can these insurance companies go before we can take action against them? What can we do to them to make them responsible? I have one of the best WC lawyers in the area but these insurance companies could care less of his demands. They defied the judge and the law.

Re: The Insurance Companies Are Corrupt So What Can We Do?

Brad,
You should probably be posting this under the California board in order for those who can help see your post/problem.
Under the old VR program, the benfits are limited to $16,000 max. A fairly big chunk of this money goes to the VR counselor...(unfortunately, as they really don't do all that much)
If you are not attending a retraining facility, the VRMA, the maintaince allowance you have been receiving should be stopped so you don't use up the money you should be receiving while in VR. There are provisions in the laws that allow an IW to attend a VR program out of state.
The other option would have been for your attorney to negotiate a lump sum buyout of your VR benefits, you could have received up to $10K for the benefits.

I'd like to refer you to another site where there are professionals who provide assistance to IW's having difficulties like yours... go here...http://www.workcompforums.com/ca/iw/...d=12&zb=188085, register and post your questions. Be precise in what you need help with, no ''rave/rant's'' or telling how corrupt the system is...the pro's won't respond to that.
But you will find the assistance/information you need to begin getting some of your problem resolved.
Good luck to you...

Re: The Insurance Companies Are Corrupt So What Can We Do?

I agree that something must be done. Here in Massachusetts I've tried to make waves, alone, for the past 3 years. It is extremely difficult if not impossible to get anyone with any clout interested in this issue. Each legislative session here there are about 3 dozen bills related to comp. Rarely is one passed, and the ones that are help the insurance industry. I had a bill filed this session that would require an injured worked to be told that he or she could tape their Impartial Exam at their own expense. It will probably never be seen again. You need a friendly legislator to push a bill. Even if that happens, bills are often attached to other bills that are unpopular so your bill dies with the others.

Please keep in mind that the insurance lobby is large and strong. Many state legislators have insurance businesses on the side. The media never does a piece about a ligitimately injured worker, only a fraud. And I believe these pieces are done at the request of a group or elected official.

I have been unable to find a single columnist or reporter in the 2 Boston newspapers to have any interest in this at all. My letters to the editor never get published. The editors aren't interested.

We definitely have an image problem. I hate to be so down about this, but I can't make any headway, and I know a fair amount about the media.

What we need is a spokesperson. Some high profile person who was hurt on the job and didn't have problems with comp who will listen to our stories.

You might try writing something for a magazine like Redbook or Ladies Home Journal. Just keep up the fight; something could break some day.

Re: The Insurance Companies Are Corrupt So What Can We Do?

Re: The Insurance Companies Are Corrupt So What Can We Do?

My congressman, Steven Lynch (D) MA, recently has one of those call in town meetings, which I attended. I was lined up to ask a question about the state of WC in the US but of course they never got to my call. About a week or so later I received a call from his office by one of his aides who was "reaching out" to me.

We had a talk abou comp., and he told me he'd get back to me. Of course, he hasn't called me, but I do have his name and number and will be getting back to him. I'll let you know what they are not going to do to help us as soon as they share their secret plan with me...

Change

g.k., thanks for the letter from Mary Bailey. Massrn, I know exactly how you feel being blown off by the congressmen's "constituent services" people. It has happened to me also. I do have one thing for anonymous, I have done my share of rounds with POR over him degrading myself and others. Besides he is not out to change anything for us, he wants change that will benefit him. I have only witnessed one "fight" and it was over something stupid in a post from 2003. There is rarely a day that goes by that I don't at least look at this site too. Other than that one isolated incident There is nothing else I have seen between two IW"S. In fact a we just got a compliment from someone that came here and looked around after posting his question. Here it is, good job everyone.

We all know change takes time, Thank You to those that continually push for it! God knows we all need you. Everyone that can please keep writing your congressmen, and governor's. If you can support any group dedicated to changing workers comp laws for the better. However, leaving here is not helping your fellow IW's NOW, the way you all know you can. If people who know how these individual states work leave, where does that put the IW's that come here, just as we did, looking for some answers? The answers that we have learned by experience mostly. Who will help them, any changes to the legislature are not likely to happen fast enough for them. I don't think it is that hard to do both. Plus you never know who the next "effective" person to get injured at work and find this site will be!